Articles Posted in Advances in Patient Safety

A recent article by the Chicago Tribune outlines the debate the State of Illinois is having in determining whether nursing homes should be required to allow video cameras to be installed in patient rooms in order to document the type of care the nurses are providing to their patients.

The article explains that there are two sides to the debate, and even patient advocates are skeptical that cameras are a good idea in all circumstances. Right now, there are about five states that allow a family to install a camera in their loved one’s room. Each state’s law is a little different, but a few things must be considered about the use of cameras in nursing homes, such as:

• The loss of privacy that nursing home residents would suffer as a result of the cameras always being on;
• The expense of the equipment and the occasional monitoring of the videos;
• The effect, both positive and negative, that recording patient interactions may have on the nursing home as a workplace;
• The admissibility of the tapes in civil or criminal suits against the nursing home and its employees; and
• The privacy of visitors, guests, and nursing home faculty and how it may be affected by the cameras.

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A recent study found that elderly women residing in nursing homes may face greater rates of mortality if they are not getting enough vitamin D. The study will appear in the Journal of Clinical Endocrinology and Metabolism, a publication of The Endocrine Society. Researchers at the Medical University of Graz, Austria, looked at a sample group of 961 residents. Members of the sample group had an average age of 83.7 years. The study found that, not only does vitamin D deficiency carry a greater risk of death, but that vitamin D deficiency may be common in nursing homes. This could have important implications for the nutritional care that female residents receive in nursing homes.

The researchers examined the 961 residents and followed up twenty-seven months later. They found that 284 individuals, roughly thirty percent of the group, had died during that time. They noted low vitamin D levels in 92.8 percent of the group members. While vitamin D deficiencies have been common knowledge among researchers for some time, the study authors said, no one has developed good strategies for treatment yet. Given the increased risk of bone fractures and other such injuries in patients with low vitamin D, the researchers urge the medical community to work on ways to remedy these deficiencies.

Low levels of vitamin D can have multiple health effects. Scientists have known about an increased rate of mortality due to vitamin D deficiency for some time, but the Graz study has helped tie it to specific populations. Vitamin D is also very important for bone health. Deficiency can cause bone damage, sometimes known as rickets, and it can contribute to an overall loss of bone density that makes fractures and breaks more likely. Some research suggests that vitamin D supplements can help with cardiovascular disease, some cancers, asthma, multiple sclerosis, immune strength, and certain neurodegenerative diseases like Parkinson’s. These claims are all controversial, and no scientific consensus exists on any of them. The U.S. Food and Drug Administration only allows the food industry to claim on its labels that vitamin D “may reduce the risk of osteoporosis.”
Vitamin D may be obtained through certain types of fish, fruits and vegetables, or foods specifically fortified with vitamin D. According to the National Institutes of Health, many people meet much of their vitamin D requirements through exposure to sunlight. Ultraviolet radiation in sunlight interacts with chemicals already present in the skin to produce vitamin D. People who spend most of their time indoors, which could include many nursing homes residents, may face vitamin D deficiencies.

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